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Presentation

Best of JAAD: Advances in Dermatology and Therapeutics

Description

The discussion covered advances in dermatology and therapeutics, focusing primarily on the implications of dupilumab in patch testing, particularly for patients with ongoing facial edema or erythema. While withdrawal from dupilumab is typically needed for patch testing, many relevant allergens still show positive results. The talk highlighted a promising pipeline of new agents, including PDE4 inhibitors and JAK inhibitors, showing broad effectiveness for conditions like hidradenitis suppurativa (HS). The relationship between organic solvent exposure and systemic sclerosis was also explored, underscoring the need for further research on causation. Moreover, hyperbaric oxygen therapy was mentioned as beneficial for calciphylaxis, alongside tissue plasminogen activator. The role of dermoscopy in diagnosing melanoma and photodynamic therapy (PDT) for various skin conditions was emphasized, particularly in severe cases like HPV-related lesions. Additionally, methods for managing hidradenitis suppurativa were discussed, highlighting the efficacy of surgical interventions even in the wake of medical treatments. The subject of alpha-gal syndrome, including its implications for biologic therapies, was introduced, stressing the importance of awareness among dermatologists. Lastly, the impact of COVID-19 vaccination on autoimmune flare-ups and the efficacy of JAK inhibitors regardless of prior treatment failure were noted. The session concluded with an acknowledgment of the essential balance between treatment options and associated risks, emphasizing the integration of diverse therapeutic strategies in dermatological care.

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Conclusions

Dupilumab does not universally require suspension for patch testing as relevant allergens remain detectable.
Emerging agents for atopic dermatitis and psoriasis show promising efficacy in clinical trials.
Hyperbaric oxygen therapy improves survival and wound healing in calciphylaxis patients.
Dermatoscopic perifollicular linear projections are a strong indicator of melanoma diagnosis.
Excision has a higher sustained clearance rate for Bowen's disease compared to topical treatments.
Chronic granulomas may be associated with rubella virus in immunocompromised individuals.
Modified red light photodynamic therapy demonstrates rapid improvement in severe acne vulgaris.
Microencapsulated formulations of tretinoin and benzoyl peroxide show effectiveness and are well tolerated.
Photodynamic therapy significantly improves papulopustular lesions in rosacea.
Adalimumab combined with surgical intervention offers superior outcomes over monotherapy for hidradenitis suppurativa.
Alpha-gal syndrome illustrates the potential for cross-reactions with biologics in patients allergic to red meat.
The risk of autoimmune disorders after mRNA COVID-19 vaccination is generally low, though case reports exist.
Switching patients from dupilumab to upadacitinib maintains clinical response regardless of prior dupilumab efficacy.

Allergol Int. 2019 Jul;68(3):296-300.
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